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Arbitration Medicare

Arbitration is a widely-used method for settling disputes between parties. During arbitration, parties submit their dispute to an impartial third person or party, usually chosen by the parties. Typically, parties... more +
Arbitration is a widely-used method for settling disputes between parties. During arbitration, parties submit their dispute to an impartial third person or party, usually chosen by the parties. Typically, parties to arbitration agree in advance to be bound by the arbitrator's decision. Arbitration is an alternative to litigation, but it shares many of the familiar features of litigation. Namely, parties to arbitration hold hearings before neutral decision-makers, present evidence and argue the merits of their position. Parties often choose arbitration due to its perceived advantages over litigation. Those perceived advantages include greater efficiency and flexibility, and lower costs. less -
American Conference Institute (ACI)

[Event] 15th Annual Advanced Forum on Managed Care Disputes and Litigation - May 2nd - 3rd, Chicago, IL

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more

McDermott Will & Emery

This Week in 340B: May 2023 #4

This weekly series provides brief summaries to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets on more than 40 340B cases to provide you with a quick...more

Hendershot Cowart P.C.

Texas ER Physicians Sue Insurer for Underpayment – Thousands of Claims at Stake

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An appeal brought before the Texas Supreme Court could unleash a wave of legal action by out-of-network ER physicians pursuing insurers for underpayment of claims. Unlike in-network providers who negotiate reimbursement...more

Dorsey & Whitney LLP

The Supreme Court - June 15, 2022

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Viking River Cruises, Inc. v. Moriana, No. 20-1573: This case involves the Federal Arbitration Act’s (FAA) preemption of a California law invalidating contractual waivers of the right to assert certain representative claims....more

Foley & Lardner LLP

Antitrust Surprises from DOJ during the Trump Administration – Predicting the Consequences

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In his 2016 presidential campaign, Donald Trump frequently expressed populist themes, rhetorically criticizing “big business” and “special interests,” and signaled an activist antitrust agenda with his comment in October 2016...more

White and Williams LLP

CMS Issues Final Rule Repealing Prohibition on Nursing Home Arbitration Agreements

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On July 16, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule, “Medicare and Medicaid Programs; Revision of Requirements for Long-Term Care Facilities: Arbitration Agreements” (84 FR 34718) (2019...more

Tucker Arensberg, P.C.

CMS Rules To Allows Nursing Homes To Use Arbitration Agreements, But Adds Certain Requirements

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After several years of debate and turmoil, late yesterday afternoon CMS issued a new Final Rule on the use of arbitration agreements by nursing homes.  History - In 2016, CMS issued a Final Rule applicable to all...more

King & Spalding

Federal Judge Blocks CMS Rule Banning Arbitration In Nursing Home Disputes

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In September, CMS announced a final rule that bans pre-dispute binding arbitration agreements related to care received in long-term care facilities. Among other things, the rule preserves the right of patients and their...more

Cadwalader, Wickersham & Taft LLP

Federal Court Blocks CMS Ban on Pre-Dispute Nursing Home Arbitration Agreements Pending Legal Challenge: What the Ruling Means for...

Earlier this week, a federal court enjoined the federal Centers for Medicare and Medicaid Services (“CMS”) from enforcing a rule, promulgated on September 28, 2016, which barred pre-dispute arbitration agreements between...more

Ballard Spahr LLP

Federal Court Enjoins U.S. Agency’s Nursing Home Arbitration Agreement Ban

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The Centers for Medicare and Medicaid Services (CMS), an agency within the U.S. Health and Human Services Department, recently issued a final rule prohibiting nursing homes and other long-term care facilities from utilizing...more

Baker Donelson

INJUNCTION GRANTED: AHCA Jumps the First Hurdle in Overturning CMS's Ban on Pre-Dispute Arbitration

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Judge Michael P. Mills granted a preliminary injunction in favor of the American Healthcare Association (AHCA) earlier today in the case of AHCA v. Burwell. A copy of the court's injunction order can be accessed here. The...more

Baker Donelson

All Eyes on Mississippi: Federal Judge Hears Argument Over CMS's New Pre-Dispute Arbitration Regulation

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A federal judge in Oxford, Mississippi, heard oral argument today in the case of AHCA v. Burwell. The case – filed by the American Healthcare Association (AHCA) three weeks ago – has been closely followed because of its...more

Polsinelli

Catching Up With the Times: CMS Reforms Long-Term Care Facility Requirements - Part II

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Following CMS publishing the biggest overhaul to federal long-term care regulations in 25 years, affected facilities must take steps to ensure they are prepared for the pending changes. On Oct. 4, CMS published the...more

Holland & Knight LLP

Ten Things to Know About the CMS Long-Term Care Requirements Final Rule

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Deadlines are looming to come into compliance with sweeping changes to the Centers for Medicare & Medicaid Services (CMS) requirements for long-term care facilities (LTC) participating in Medicare and Medicaid. The CMS final...more

Polsinelli

Catching Up With the Times: CMS Reforms Long-Term Care Facility Requirements - Part I

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On Oct. 4, CMS published the biggest overhaul to federal long-term care regulations since 1991. The lengthy Final Rule reforms the requirements for long-term care facilities participating in Medicare and Medicaid. CMS...more

Arnall Golden Gregory LLP

CMS Federal Nursing Home Arbitration Agreement Ban Is Not Likely to Remain Unchallenged

People in this country have long enjoyed the right to contract. Included with that right is the ability to agree to resolve potential disputes out of court and in arbitration. The Centers for Medicare & Medicaid Services’...more

Cadwalader, Wickersham & Taft LLP

In Final Rule, CMS Acts to Bar Pre-Dispute Binding Arbitration Agreements With Nursing Home Residents Effective November 28, 2016

On September 28, 2016, the federal Centers for Medicare and Medicaid Services (“CMS”) issued its long-awaited final rule that, among other things, prohibits skilled nursing facilities (“SNFs”) and nursing facilities (“NFs”)...more

Ballard Spahr LLP

U.S. Agency Prohibits Nursing Home Arbitration Agreements

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The Centers for Medicare and Medicaid Services (CMS), an agency within the U.S. Health and Human Services Department, has issued a final rule that includes prohibiting nursing homes and other long-term care facilities from...more

BakerHostetler

Medicare Advantage Plan Arbitration Clauses Preempted by Medicare Appeals Process

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The Arizona Supreme Court, in an interesting case involving a Medicare-related coverage dispute between a Medicare Advantage plan administrator, United Behavioral Health (UBH), and two inpatient psychiatric care providers,...more

JAMS

Health Care Matters, Summer 2016

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Special Masters in Health Care Antitrust Merger Cases: Resolving the Conflicting Interests - One of the most challenging aspects of antitrust cases in the health care field is the rich mixture of public interest...more

Arnall Golden Gregory LLP

A Federal Ban on Arbitration Agreements in Nursing Homes? Senators’ Comment on CMS Proposed Rule Ignores Congressional Intent and...

In July, the Centers for Medicare & Medicaid Services (CMS) proposed changes to the requirements for long-term care facilities, including implementation of new restrictions on the use of binding arbitration agreements between...more

Polsinelli

Impending Deadline: CMS Issues Proposed Rule Reform for Long Term Care Facilities – Part 3 of 4

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On July 16, 2015, the Federal Register published Centers for Medicare and Medicaid Services’ (CMS) proposed rule to reform the requirements for Long Term Care Facilities participating in Medicare and Medicaid. CMS will be...more

Faegre Drinker Biddle & Reath LLP

Can an Arbitrator Rule Against a Hospital for Not Violating the Anti-Kickback Statute?

Here’s a nightmare. An arbitrator rules against your hospital for failing to honor an agreement to refer Medicare patients to a home health agency. Why? Because the home health agency paid your hospital good money for the...more

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